THE enlarged pores they are very common skin imperfections, affecting women and men, without distinction.
At the level of the skin surface, the pores are almost invisible “openings” which generally coincide with the outlet of the sebaceous glands. Their presence is important for skin transpiration and to give the epidermis a hydrated and soft appearance.
Usually, skin pores are not problematic, unless they increase in size and become so noticeable as to be unsightly. In fact, it may happen that these structures become blocked and enlarged, constituting an evident change in the skin surface.
One of the main causes of dilatation is oily skin: skin pores often tend to enlarge in the event of overproduction of sebum and when they are no longer able to contain an excess of waste substances and dead cells.
The problem of enlarged pores can be difficult to treat, but it can be kept at bay already by adopting a healthy diet and regular facial cleansing. There is also a whole series of dermatological and cosmetic treatments that can help make this defect less evident.
Enlarged pores are skin blemishes affecting individuals of a wide range of ages (10-70 years), of both sexes. This condition can be defined:
a visible expansion of circular shape and dimensions between 0.1 and 0.6 mm2which makes the uneven skin tone.
The enlarged pores are not stable skin structures, but dynamic (continuously changing).
The possible causes of enlarged pores are numerous and include many exogenous and endogenous factors such as genetic predisposition, ageing, chronic exposure to ultraviolet light or to comedogenic xenobiotics (environmental toxicants, alcohol, drugs, pesticides, chlorinated hydrocarbons, etc.), acne and seborrhea.
Although this blemish is not medically concerning, many people worry about having enlarged pores because they are a cosmetic defect.
“Porexia” is the name with which dermatologists have renamed the symptoms related to the presence of enlarged pores on the face.
The skin releases sebum, which is a substance that our body’s glands produce, through tiny openings called pores. These structures are, therefore, indispensable for the normal trophism of the skin and it would not be possible to get rid of them permanently. However, some pores appear more dilated and larger than others.
THE causal mechanisms of dilated pores are mainly three:
- Excessive production of sebum (it is no coincidence that the problem mainly affects people who have one skin that tends to be oily);
- Decreased elasticity around pores (secondary to the loss of elastic fibers, collagen and proteins from the extracellular matrix);
- Increased volume of the hair follicle (therefore, the size of the dermal papilla and the thickness of the hairs also affect the dilation of the pores).
The possible exogenous and endogenous factors that contribute to the dilation of the pores are:
- Chronic acne;
- Action of sex hormones (including androgens and, in women, progesterone during ovulation);
- Genetic predisposition;
- Damage associated with exposure to ultraviolet light;
- Exposure to comedogenic xenobiotics (environmental toxicants, alcohol, drugs, pesticides, chlorinated hydrocarbons, etc.);
- Poor daily care for the care of the skin surface (e.g. use of inadequate cosmetics and insufficient hygiene).
The dilation of pores can be influenced by the application of occlusive make-up or make-up not suitable for your skin type. Another wrong habit is that of many women, of not removing make-up before going to sleep; in this way, the already open pores become clogged.
Aging is another factor that tends to make this flaw worse, particularly when combined with the harm from excessive sun exposure. Over the years, in fact, the skin loses the usual elasticity and integrity it possesses at a young age; this can predispose to enlargement of pores.
Given the various factors that can cause dilation of the pores, the most suitable treatment must be established “tailored” for each patient.
Options include drugs and therapies that can:
- Reduce sebum production;
- Improve skin elasticity.
Oral and topical drug treatment
In the presence of dilated pores, a treatment based on isotretinoin (13-cis retinoic acid)a powerful inhibitor of sebum production.
This drug works by suppressing the activity of the sebaceous gland and normalizing the keratinization pattern within the follicle.
The use of drugs with anti-androgenic action on the other hand, it can induce a reduction in sebum secretion by acting on the cells of the pilosebaceous unit (including follicular keratinocytes and sebocytes) sensitive to the action of these hormones.
Medicines that can affect sebum production also include: combined hormonal contraceptives such as spironolactone (synthetic steroid compound with structure similar to progesterone and aldosterone) and cyproterone acetate (progestin with anti-androgenic effect).
As far as topical solutions are concerned, it is possible to try using ingredients able to improve the trophism of oily skin. To reduce the oily appearance of the skin and the imperfections associated with excess sebum, the leaf extract of Orthosiphon stamineus.
Other active ingredients that can contribute to the reduction of sebaceous secretion and improve the appearance of the skin, if applied topically, aresalicylic acidthe L-carnitine and the 2% niacinamide.
In the presence of dilated pores, the recommended cleansers are simple solutions of surfactants, free of oils (oil-free), waxes or fatty agents that could aggravate the condition.
In addition, you should always check that moisturizers, sunscreens and other topical products do not contain comedogenic substances, i.e. substances that promote the formation of comedones (blackheads). These agents can be found in various cosmetic preparations (emulsions, dyes, sunscreens, preservatives, excipients, etc.).
Laser treatment and botulinum toxin
Possible options that can be considered to reduce enlarged pores include: photodynamic therapy, diode lasers And non-ablative radiofrequency. These interventions aim to induce a selective necrosis of the sebaceous glands.
Recently, to manage the problem of dilated pores, it has also been suggested the use of intradermal botox. This toxin can be useful for reducing the production of sebum and the formation of related skin blemishes.
Finally, there are also treatments for dermabrasion which allow you to even out the skin surface and eliminate dilated pores in just a few sessions.
Diet can be an important source of substrate for sebum synthesis.
In particular, diets rich in carbohydrates with a high glycemic index and dairy products can predispose to the formation of enlarged pores. These foods should therefore be limited or, if possible, eliminated.
The treatments useful for improving the elasticity of the skin are different.
THE retinoids increase the content of collagen in the upper papillary dermis, increasing its synthesis and inhibiting its degeneration; these compounds include tretinoin and tazarotene.
Among the treatments of aesthetic medicine useful for minimizing the pores fall, however, the IPL (pulsed light)the fractional bipolar radiofrequency and the laser from the wavelength of 2790 nm with a crystal of yttrium scandium gallium garnet as the active medium. Again, the goal is to act on the collagen that characterizes our skin and thus determine a narrowing of the pores.
Finally, the Sun protection it is essential at any age and must necessarily be used in addition to all the other interventions implemented to counteract skin aging.
In some cases, the size of enlarged pores can be reduced with hair removal. Among the most useful techniques for improving the skin is the photothermolysis (laser hair removal and pulsed light).